Question

Compare and contrast the course of illness, symptoms, and nursing interventions for the sub-types of schizophrenia and for associated disorders such as schizoaffective disorder.

Answer 1

schizophrenia and schizoaffective disorders are similar kind of mental disorders wherein schizoaffective disorders are marked with schizophrenia symptoms such as hallucinations or delusions along with mood disorder symptoms such as depression or mania.

Subtypes of schizophrenia are :

1. Paranoid schizophrenia
2. Disorganised schizophrenia
3. Catatonic schizophrenia
4. Undifferentiated schizophrenia
5. Residual schizophrenia

Types of Schizoaffective disorders are :

1. Bipolar type - mania and depression.
2. Depressive type- depression without mania.

In both schizophrenia and schizoaffective disorders hallucinations(false sensory perceptions) and delusions(false beliefs) are common. In both disorders, the initial break is more likely to occur during the early 20s.

In schizophrenia the psychotic symptoms are chronic and persistent whereas in schizoaffective disorders the psychotic symptoms are episodic.

When we look at the course of illness of both the mental disorders, its clear that both are chronic disorders which can stay life long. However, with proper treatment it can be controlled to a good extent that the affected person can lead an almost normal life. Each person's recovery will be different based on the patient's rehabilitation success. Even though it is believed that the severity of the disease gets less severe with increasing age. But, there exist patients whose condition got more severe with increasing age.

Nursing interventions for schizophrenia include :

1. Establishment of trust and rapport.
2. Ensure the safety of the patient.
3. Ensure the adequate intake of food and fluids.
4. Deal with the hallucinations by telling the patient that we can't see, hear or feel them but we understand that they are real to him.
5. Monitor drug therapy.
6. Involve family in the payment treatment.
7. Promoting of social skills.
8. Promote the patient to recover from activity intolerance.

In the case of Schizoaffective disorders, the nursing interventions are almost similar, except for the medication which are administered. Schizophrenia patients are administered with antipsychtotics and schizoaffective disorder patients are administered with antipsychtotics along with mood stabilising medications.